Abstract B100: Developing an integrated understanding of access to care and tumor characteristics patterns by race and age in the Carolina Breast Cancer Study Phase III, 2008 – 2013

Purpose: Understanding breast cancer mortality disparities by race and age is complex due to disease heterogeneity, comorbid disease, and the range of factors influencing access to care. We compared socioeconomic status (SES) and comorbidity factors from the Carolina Breast Cancer Study Phase III (CBCS3, 2008-2013) to North Carolina and examined factors related to race and age in CBCS. Methods: Distributions of SES and comorbidity factors in CBCS3 cases were compared to those of North Carolina women in the 2010 Behavioral Risk Factor Surveillance Study. Using latent class analysis of CBCS3 data, we identified covariate patterns by SES/comorbidities, barriers to care, and tumor characteristics and examined their associations with race and age using multinomial logistic regression. Results: Major SES and comorbidity patterns in CBCS3 participants were generally similar to patterns in the state. Latent classes were identified for SES/comorbidities, barriers to care, and tumor characteristics that varied by race and age. Compared to white women, black women had lower SES (odds ratio (OR)=6.3, 95% confidence interval (CI); 5.2, 7.8), more barriers to care (OR=5.6, 95% CI; 3.9, 8.1) and several aggregated tumor aggressiveness features. Compared to older women, younger women had higher SES (OR=0.5, 95% CI; 0.4, 0.6), more barriers to care (OR=2.1, 95% CI; 1.6, 2.9) and aggregated tumor aggressiveness features. Conclusions: CBCS3 is representative of North Carolina on comparable factors. Patterns of access to care and tumor characteristics are intertwined with race and age, suggesting that interventions to address disparities will need to target both access and biology.

Citation Format: Marc A Emerson, Yvonne M Golightly, Xianming Tan, Allison E Aiello, Katherine E Reeder-Hayes, Andrew F Olshan, Shelley A Earp, Melissa Troester. Developing an integrated understanding of access to care and tumor characteristics patterns by race and age in the Carolina Breast Cancer Study Phase III, 2008 – 2013 [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr B100.